Oncology (General Cancer)/swollen axillary lymph nodes
QUESTION: Good day Doc:
i noticed the other day that my husband has a lump beside his left armpit, and that it looks like a lump of fat which the other armpit doesnt have, so he went to the doctor to have it checked, and an ultrasound procedure was done ,they found an oval shaped enlarged lymph node measuring 3.93 x 1.9x 2.04 cm, and multiple enlarged nodes not bigger that 2 cm, on the right armpit a few enlarged flat fat-laden lymph nodes were seen, ranging from 1.62 cm to 2.5 cm. so his internist recommended him to a surgeon , the doctor told him its nothing to be over alarmed with for now, might be infection but a biopsy is mandatory to rule out anything bad, his chest xray is normal, blood works (including CBC) is normal over the years, and he doesnt have any other symptoms like weight loss, night sweats other than the swollen lymph nodes. he himself is not overly concerned but i am worried sick, the more i research about lymphoma and cancers the more i am panicking, the biopsy by the way will be on next tuesday, please advise, thanks a lot!
ANSWER: I agree with your doctors. A biopsy is necessary. It may be nothing serious, but if it is a lymphoma or hodgkin's disease, it is very likely to be curable, or at leaset controllable. So don't be worried sick. Science and medicine have made enormous progress dealing with malignancies of the lymphatic system. Keep me posted on the results of the biopsy.
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QUESTION: Thank you Doc, from the description if it isnt lymphoma what could it be? Could it be just infection of some sort? Since he doesnt hav any other symptoms aside from enlarged lymph nodes, if it is lymphoma it should still be in the early stages? He's 44 years old, has a family history of thyroid problems , could thyroid nodules manifest near the armpits? Thank you again
ANSWER: The differential diagnosis of enlarged painless lymph nodes which are not "hard" in consistency would primarily be one of the sixteen different kinds of lymphoma, or Hodgkin's disease. It's possible that a so called "solid tumor" cancer could present this way, but unlikely. Infected nodes are usually tender, and tend to shrink and become less tender as time goes on. There is an unusual disease called sarcoidosis that can resemble a lymphoma. And finally, we see cases where despite enlarged nodes, the tissue does not look or behave like a lymphoma (reactive lymphadenitis). We suspect some of these "benign" cases are reactions to viral infections (the virus that causes mononucleosis, for example). So again, a biopsy is very important, but there are other things it could be.
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QUESTION: Hi doctor. Biopsy results hasnt come out yet but surgeon who performed the procedure told me that big chance is lymphoma, pathologist said immuno stain will be added to the test because initial result is atypical cells, chest xray , blood work, and abdominal ultrasound all clear,organs are not enlarged except they found a 1.5x1.2 cm hypoechoic hepatic node beside the liver. Aside from that my husband has no symptoms as for the moment except for itchy legs, but otherwise good appetite and energetic, so is it better to be this way i mean looks like its not late stage? But as i read from the internet lymphoma can be treated at any stages? You mentioned that its controllable so theres hope thank you
I'm sure the further testing will help decide what to do next. If there is evidence of lymphoma, generally a PET scan would be done, to help stage the disease. That and the pathology would determine the treatment. As I said, if this is a lymphoma or HOdgkin's disease, it is likely that it can be controlled. Most of the time, depending on the disease, control leads to cure, or at least long term control. Please let me know the final diagnosis. So far it sounds promising.